Benefits Specialist

The job of Benefits Specialist is done for the purpose/s of processing/ researching insurance claims; ensuring employee proof of coverage and accurate billing; resolving insurance benefit issues; providing benefit information to new and current employees, providers and/or administrators; researching providers, costs and services for administrative review.

This job reports to Human Resources Manager

• Assists employees, beneficiaries and/or insurance providers for the purpose of verifying eligibility, conveying information related to over ten different plans, and processing claims.
• Audits and reconciles a variety of benefit information (e.g. payroll deductions, voluntary insurance billings, self
  -funded benefits program budgets, Health Savings Account etc.) for the purpose of accurately compensating employees and ensuring compliance with all established accounting and insurance regulations.
• Calculates and enters a variety of benefit deductions into district payroll system(s) (e.g. benefit deductions, HRS contributions, prorated premiums, etc.) for the purpose of ensuring that employee benefit deductions are maintained accurately and within all relevant rules, laws and regulations.
• Coordinates summary plan document with new vendors and WSBAIT for the purpose of keeping abreast of changes in the insurance industry, and keeping costs down.
• Distributes documents (e.g. open enrollment packets, new/change forms, fringe benefit packages, flyers, identification cards, etc.) for the purpose of providing information and proof of insurance coverage/s.
• Maintains files and records pertaining to employee benefits (e.g. leave of absence records, applications, revolving accounts, etc.) for the purpose of accurately compensating employees and ensuring an up-to- date reference and audit trail.
• Manages retiree accounts for the purpose of accurate spreadsheets and properly reconciled accounts.
• Organizes and administers employee benefits communications processes (e.g. new employee orientations, benefits fairs, written and electric employee communications, open enrollment periods, etc.) for the purpose of receiving and/or conveying information processing applications.
• Prepares and/or processes a wide variety of written materials (e.g. reports, memos, letters, employee benefits forms, retiree insurance billings, benefits applications, forms, enrollment changes, etc.) for the purpose of documenting activities, providing written reference, conveying information and/or ensuring that established accounting practices are maintained.
• Processes a variety of benefit information (e.g. flex benefits, long term disability, open enrollment activities, ACRS benefits program, weekly deposits, district billings, applications, wire transfers, etc.) for the purpose of completing enrollment/changes within program guidelines.
• Receives workplace safety and workers compensation information (e.g. first report of injury reports, medical bills, return-to-work information, etc.) for the purpose of managing claim costs, assisting injured employees and ensuring compliance with established regulations.
• Reconciles enrollment forms and billings to employee records (e.g. health, dental, vision, etc.) for the purpose of ensuring accurate eligibility and payment information and complying with contract provisions.
• Researches issues and/or discrepancies regarding insurance claims as needed for the purpose of ensuring that employee claims are paid accurately and in compliance with current insurance policies and regulations.

• Assists other personnel, as may be required, for the purpose of ensuring an efficient and effective work environment.

SKILLS are required to perform single, technical tasks with a need to occasionally upgrade skills in order to meet changing job conditions. Specific skill based competencies required to satisfactorily perform the functions of the job include: operating standard office equipment; performing standard bookkeeping; planning and managing projects; preparing and maintaining accurate records; and using pertinent software applications.

KNOWLEDGE is required to perform algebra and/or geometry; read technical information, compose a variety of documents, and/or facilitate group discussions; and solve practical problems. Specific knowledge based competencies required to satisfactorily perform the functions of the job include: accounting/bookkeeping principles;…